Beclometasone inhalers

Beclometasone is a type of medicine known as a steroid (also called a corticosteroid). It's mainly used for asthma, but also sometimes for chronic obstructive pulmonary disease (COPD).

Steroids closely copy the effects of natural hormones produced in your adrenal glands. The adrenal glands are above your kidneys.

Steroid inhalers work as a preventer by calming down your immune system. This reduces the swelling in your lungs that makes it difficult to breathe.

You can take beclometasone using an inhaler (sometimes called a "puffer"), which is usually brown or beige, or sometimes red or pink. This is called a "preventer" inhaler because it helps to prevent you from getting symptoms.

Beclometasone on its own does not work as a reliever (to relieve any symptoms when you get them). It cannot treat an asthma attack when you suddenly get coughing, wheezing and breathlessness.

Some inhalers contain beclometasone mixed with other medicines that help your breathing (bronchodilators).

A beclometasone inhaler containing formoterol (brand names include Fostair, Luforbec and Bibecfo) may be used as both a preventer and a reliever for asthma.

Beclometasone also comes as

• nose spray (nasal spray) – for hay fever and cold-like symptoms caused by common allergies (rhinitis)
• cream and ointment – for skin conditions such as eczema and psoriasis
• tablets – for ulcerative colitis

Most adults can use beclometasone inhalers for asthma or COPD.

Most infants and children can use beclometasone inhalers for asthma. Some brands may only be suitable for older children aged 5 years old and above.

Beclometasone inhalers are not suitable for some people. To make sure they're safe for you, tell your doctor or nurse if you:

• have ever had an allergic reaction to beclometasone or any other medicine
• cannot have alcohol for any reason (some brands contain a very small amount of alcohol)
• have ever had TB (tuberculosis)
• are pregnant or trying to get pregnant

The usual dose of beclometasone using an inhaler as a preventer for asthma or COPD is 1 or 2 puffs, twice a day.

It's important to use your beclometasone inhaler regularly to manage your symptoms. Use it regularly, even if you do not have any symptoms. After using your inhaler, always put the lid back on to keep it clean.

Beclometasone inhalers come in different strengths. Your doctor, or asthma or respiratory nurse, will tell you which strength is right for you. Always follow their instructions. They may tell you to use your inhaler more often, up to 4 times a day, or to have more than 2 puffs at a time. This depends on how bad your breathing is and which inhaler you're using.

If your beclometasone inhaler also contains formoterol, you may be advised to use it as a preventer and also as a reliever for asthma when you're wheezy or tight chested. In this case, doses can be up to 8 puffs a day in total. Let your doctor or nurse know if you feel you need to use more than 8 puffs in a day.

Your dose may go up or down depending on how bad your breathing is. You'll be prescribed the lowest dose that controls your symptoms.

If you've agreed a personal action plan with your doctor or nurse, follow your action plan.

Talk to your doctor or nurse if your breathing seems to be getting worse.

Different types of inhalers

There are different types of beclometasone inhaler, including:

• pressurised metered dose inhalers (pMDIs), which give the medicine in a spray form (aerosol) – you can use these with a spacer
• breath actuated inhalers (BAIs) – these release a spray of medicine as you inhale
• dry powder inhalers (DPIs) – these give the medicine in the form of a dry powder instead of a spray

Speak to your doctor, nurse or pharmacist about which inhaler type is best for you or your child.

It's very important to use your inhaler properly. This is so you get the right amount of beclometasone into your lungs and the most benefit from your medicine.

If you or your child find it difficult to use one type of inhaler, speak to your doctor, nurse or pharmacist about trying a different type.

Before using your inhaler, read the information leaflet that came with it. This leaflet contains instructions and diagrams to show you how to use the inhaler, how to keep it clean, and how long to use it before getting a replacement.

Do not use anyone else's beclometasone inhaler. Your inhaler may be different to a friend's or relative's. Their inhaler might contain a different dose of beclometasone.

To get the most from your inhaler, it's important to have your technique checked regularly.

If you're not sure how to use your inhaler, or your technique has not been checked for a year, ask your doctor, nurse or a pharmacist to watch you use it.

Remove the mouthpiece cover completely before using your inhaler. Check the inside and outside of the mouthpiece to make sure it's clean and there's nothing inside it. Shake the inhaler 4 or 5 times to remove any loose objects.

After use, replace the mouthpiece cover straight away. Firmly push it and make sure it clicks into place.

Always store your inhaler with the mouthpiece cover on.

A spacer is recommended for anyone having high doses and using a pressurised metered dose inhaler (pMDI) that contains a steroid. They're always recommended for children aged 15 years old and under.

As well as making your inhaler easier to use, spacers can also reduce the risk of steroid side effects affecting your mouth and throat.

A spacer is a plastic container with a mouthpiece and a hole for the inhaler. It makes it easier to get the right amount of beclometasone into your lungs. For young children they're available with a face mask.

Your doctor, nurse or a pharmacist can show you how to use a spacer with your inhaler.

Watch a video

Asthma + Lung UK has some short videos showing you how to use your inhaler to help you manage your symptoms. You can search by type of inhaler and by brand (such as Clenil, Fostair or Qvar).

If you use a pressurised metered dose inhaler for example, you can watch a pMDI video.

You'll usually use your beclometasone inhaler for a long time. It helps prevent your asthma or COPD getting worse.

It's important to keep using your inhaler even if you feel better.

Do not stop using beclometasone suddenly, even if you feel better, without speaking to your doctor or nurse first.

If you have an inhaler to control your asthma or COPD, your breathing problems may return if you suddenly stop using it. You might feel wheezy or short of breath. Your chest may feel tight and you could start to cough.

Suddenly stopping treatment can make you feel unwell. Symptoms can include feeling drowsy, sick or tired, headaches and loss of appetite.

Use your inhaler as soon as you remember, unless it's almost time for your next dose. In this case, skip the missed one and take your next dose at the usual time.

Do not take 2 doses to make up for a forgotten dose.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Using too much beclometasone is unlikely to harm you.

If you're worried, talk to your doctor or a pharmacist.

If you use a steroid inhaler regularly, ask your doctor, nurse or a pharmacist if you need to carry a blue steroid card, or a red steroid emergency card, or both.

If you need any medical or dental treatment, show your blue or red steroid card to the doctor, dentist or pharmacist so they know that you're taking beclometasone.

These common side effects of beclometasone inhalers may happen in more than 1 in 100 people. There are things you can do to help cope with them:

If you get oral thrush, a fungal infection that causes white patches, redness and soreness in your mouth, try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening.

You can also ask a pharmacist to recommend a suitable treatment such as an antifungal mouth gel. They may suggest that you see your doctor to discuss the best treatment.

Keep using your beclomethasone inhaler while using any antifungal treatment.

Try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening.

Keep taking the medicine but talk to your doctor, nurse or a pharmacist if the advice on how to cope does not help and these side effects bother you or do not go away. They can check that you're using your inhaler correctly.

Using a spacer with your beclometasone inhaler can also help to prevent side effects in your mouth.

It's unusual to have any serious side effects when using a beclometasone inhaler.

Side effects are more likely if you're on a higher dose of beclometasone for a long time (more than a few months).

Speak to your GP if you get "moon face" (a puffy, rounded face), weight gain in the upper back or belly. This happens gradually and can be a sign of Cushing's syndrome.

Call your doctor or call 111 now if you get:

• high temperature, chills, a very sore throat, ear or sinus pain, a cough, coughing up more mucus (phlegm), a change in colour of your mucus, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
• a very upset stomach or you're being sick (vomiting), feeling very dizzy or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal insufficiency
• changes in your eyesight, such as blurred vision or a cloudy lens in the eye – these can be signs of increased pressure in your eyes (glaucoma) or a cataract

Serious allergic reaction

In rare cases, beclometasone inhalers may cause a serious allergic reaction (anaphylaxis).

This is different to an asthma attack. If you or your child have asthma symptoms, such as wheezing or tightness in the chest or throat, use a reliever inhaler. If the symptoms do not improve or get worse, call 999 or go to A&E.

Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Using beclometasone inhalers at higher doses for a long time could possibly slow down the normal growth of children and teenagers. But the risk of this happening is very low, less than 1 in 10,000 people.

Talk to your doctor or asthma nurse if you're worried. They'll be able to explain the benefits and risks of giving your child beclometasone inhalers.

Your child's doctor or asthma nurse will monitor their height and weight on an annual basis for as long as they're taking this medicine. This will help them spot any slowing down of your child's growth and change their treatment if needed.

Even if your child's growth slows down, it does not seem to have much effect on their overall adult height.

These are not all the side effects of beclometasone inhalers. For a full list see the leaflet inside your medicines packet.

Beclometasone inhalers may be used during pregnancy.

Since it's taken into the lungs, very little of the medicine gets into your bloodstream and almost none gets to your baby. Even if a small amount does get to your baby, it will not harm them.

It's important to keep using your beclometasone inhaler in pregnancy to ensure that your asthma or chronic obstructive pulmonary disease (COPD) is well controlled. Having a lung condition and breathing difficulties is dangerous for you and your baby.

You may find that you need extra beclometasone during pregnancy. This is fine and it's safe to increase the dose if you need to.

If your asthma or COPD get worse during pregnancy then contact your doctor, midwife or specialist.

It's OK to use your beclometasone inhaler as normal while you're breastfeeding.

Although there is no information about using beclometasone inhalers while breastfeeding, only tiny amounts are likely to be in breast milk. It's very unlikely to cause any side effects in your baby.

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

There's no evidence to suggest that taking beclometasone reduces fertility in either men or women.

Tell your doctor if you're:

• trying to get pregnant
• pregnant
• breastfeeding

Beclometasone inhalers can be used with most other medicines. But some medicines may affect your inhaler and increase the chance of having side effects.

Check with a pharmacist or your doctor if you're taking:

• medicines used to treat HIV such as ritonavir or cobicistat
• other medicines that contain steroids such as eczema creams, other asthma inhalers, steroid tablets, injections, nasal sprays or eye or nose drops
• medicines that could be affected by alcohol such as disulfiram or metronidazole. This is because some brands of beclometasone inhaler contain a very small amount of alcohol – check the leaflet that comes with your inhaler

There's not enough information to say that complementary medicines, herbal remedies and supplements are safe to take while using a beclometasone inhaler. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.